The goal of this application is to expand my mentoring of medical students, post-doctoral fellows, and junior faculty in the conduct of patient-oriented research. My career has been devoted to conducting high quality patient-oriented research in the area of complications of chronic viral infections, with a focus on HIV disease. As the recipient of outstanding mentoring and training, including a PhD in Clinical Investigation, I am committed to training the next generation of clinical investigators. My longstanding research in the area of metabolic complications of HIV and its therapy and recent research in another chronic retroviral infection, HTLV-1 infection in Brazil, as detailed in the following specific aims, will serve as vehicles for training clinical investigators domestically and internationally: 1) To investigate metabolic complications of HIV disease and its therapy; 2) To investigate metabolic complications of HCV/HIV co-infection; and, 3) To characterize the clinical manifestations of HTLV-1 infection. Specific clinical research projects that are funded by R01-DK065515, a supplement from NIAID, and the AIDS Clinical Trials Group, in conjunction with an outstanding institutional environment and resources for education, will enable me to train the next generation of investigators in high quality, hypothesis-driven, patient-oriented research. Furthermore, support from the Fogarty International Center and a T32 training grant will provide a steady stream of high quality domestic and international trainees. This application describes a detailed mentoring plan for trainees, which includes the K30 Masters in Clinical Investigation program for which I developed and co-direct a Clinical Trials course. At this juncture in my career, the protected time afforded by a K24 award is critical to allow me to expand my domestic and international clinical research programs and mentoring activities. To date, I have been able to use my methodologic skills to improve the quality of patient-oriented research being conducted as part of the longstanding NIH-funded Cornell-Bahia collaboration in tropical diseases research. The K24 award will permit me to increase collaborations with colleagues at the Federal University of Bahia in Brazil, assisting in the design, conduct, and analysis of patient-oriented research in neglected tropical diseases of public health importance, including HTLV-1 infection.